The researchers calculated the 20-year risk for death among stroke patients who survived 30 days or more. For TIA, the 20-year mortality risk was 24.9%; 29 patients had died, while only 11.2 deaths were expected, translating into a standardized mortality ratio (SMR) of 2.6 (P<.001).

These numbers only increased for ischemic and hemorrhagic stroke. Nine patients died of hemorrhagic stroke compared with 2.3 expected deaths (SMR=3.9; P<.001) and 111 died of ischemic stroke compared with 28.6 expected deaths (SMR=3.9; P<.001).

“To minimize the higher-than-expected mortality, the underlying cause of the stroke (eg, atherosclerosis, atrial fibrillation, valvular heart disease) and cause of the symptomatic cardiovascular disease (eg, hypertension, smoking, alcohol abuse) need to be diagnosed accurately at presentation, treated appropriately and, if possible, eliminated,” wrote editorialists commenting on the study. “If elimination of the cause is not possible, long-term follow-up and control of the disease and its risk factors need to be maintained vigilantly.”

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